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Motor milestones for infants: Developmental Milestones for All Ages

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Developmental Milestones for All Ages

Developmental Milestones for Babies and Children

What are developmental milestones?

Milestones are behavioral or physical checkpoints in children’s development as they grow. All of our developmental milestones are validated by American Academy of Pediatrics findings.

These are the core skills infants and toddlers should be reaching. Week by week and month by month, you can check in on baby’s growth and development by following baby’s milestones.

Want these milestones in a handheld guide?

Order Baby’s First Year Milestone Guide

How are the milestones organized?

We have divided our developmental milestones into the core parts of child development:

  • Motor milestones: When will baby sit independently? When will baby start to crawl? Motor milestones track baby’s gross motor skills (in their core and upper body) and fine motor skills (in their hands and feet).
  • Sensory milestones: When will baby be able to visually track objects? When will baby have a regular sleep schedule? Sensory milestones track the development of baby’s 7 senses.
  • Communication milestones: When will baby say their first words? When do toddlers begin responding to questions? These language milestones are the building blocks to baby’s communication and social skills.
  • Feeding milestones: When is baby ready for finger foods? How long should baby nurse for? These milestones help track when babies start new phases of feeding.

Remember, all babies are different! Milestones mark the month most babies start a certain behavior or ability based on baby’s age, but exact timing will vary. If you have any concerns, request an appointment with a healthcare provider.

Early detection allows for early correction or support. I have witnessed the effect this has a on child’s trajectory hundreds of times over my pediatric career. My favorite time is looking back with parents when their children are older and reflecting on the significance of early intervention. We are both grateful.

-Lori Walsh, MD, FAAP

Be sure to adjust for prematurity. If your child is missing any milestones, be sure to talk with your healthcare provider.

0-3 Month Milestones

Motor Milestones
  • While lying on tummy, pushes up on arms
  • While lying on tummy, lifts and holds head up
  • Able to move fists from closed to open
  • Able to bring hands to mouth
  • Moves legs and arms off of surface when excited
Sensory Milestones
  • While lying on back, attempts to reach for a toy held above their chest
  • While lying on back, visually tracks a moving toy from side to side
  • While lying on back, keeps head centered to watch faces or toys
  • Able to calm with rocking, touching, and gentle sounds
  • Enjoys a variety of movements
Communication Milestones
  • Quiets or smiles in response to sound or voice
  • Turns head towards sound or voice
  • Shows interest in faces
  • Makes eye contact
  • Cries differently for different needs (e. g. hungry vs. tired)
  • Coos and smiles
Feeding Milestones
  • Latches onto nipple or bottle
  • Tongue moves forward and back to suck
  • Drinks 2 oz. to 6 oz. of liquid per feeding, 6 times per day
  • Sucks and swallows well during feeding

See Videos of 0-3 Month Milestones

4-6 Month Milestones

Motor Milestones
  • Uses hands to support self while sitting
  • Rolls from back to tummy and tummy to back
  • While standing with support, accepts entire weight with legs
  • Reaches for nearby toys while on tummy
  • While lying on back, reaches both hands to play with feet
  • While lying on back, transfers a toy from one hand to the other
Sensory Milestones
  • Uses both hands to explore toys
  • Generally happy when not hungry or tired
  • Brings hands and objects to mouth
  • Able to calm with rocking, touching, and gentle sounds
  • Is not upset by everyday sounds
  • Enjoys a variety of movements
Communication Milestones
  • Reacts to sudden noises or sounds
  • Listens and responds when spoken to
  • Begins to use consonant sounds in babbling, e. g. “da, da, da”
  • Makes different kinds of sounds to express feelings
  • Notices toys that make sounds
  • Uses babbling to get attention
Feeding Milestones
  • Shows interest in food
  • Opens mouth as spoon approaches
  • Moves pureed food from front of mouth to back
  • Begins to eat cereals and pureed foods – Smooth, pureed food (single ingredient only), like carrots, sweet potato, squash, apples, pears

See Videos of 4-6 Month Milestones

7-9 Month Milestones

Motor Milestones
  • Sits without support
  • Sits and reaches for toys without falling
  • Moves from tummy or back into sitting
  • Starts to move with alternate leg and arm movement e. g. creeping, crawling
  • Picks up head and pushes through elbows during Tummy Time
  • Turns head to visually track objects while sitting
  • Shows more control while rolling and sitting
  • Picks up small objects with thumbs and fingers
  • In simple play imitates others
Sensory Milestones
  • Enjoys a variety of movements – bouncing up and down, rocking back and forth
  • Explores and examines an object using both hands and mouth
  • Turns several pages of a chunky (board) book at once
  • Experiments with the amount of force needed to pick up different objects
  • Focuses on objects near and far
  • Investigates shapes, sizes, and textures of toys and surroundings
  • Observes environment from a variety of positions – while lying on back or tummy, sitting, crawling, and standing with assistance
Communication Milestones
  • Uses increased variety of sounds and syllable combinations in babbling
  • Looks at familiar objects and people when named
  • Recognizes sound of their name
  • Participates in two-way communication
  • Follows some routine commands when paired with gestures
  • Shows recognition of commonly used words
  • Simple gestures, e. g. shaking head for “no”
  • Imitates sounds
Feeding Milestones
  • In a highchair, holds and drinks from a bottle
  • Begins to eat thicker pureed and mashed table foods
  • Enjoys chew toys that can massage sore and swollen gums during teething
  • Stays full longer after eating
  • Starts to look and reach for objects, such as, food that is nearby
  • Shows strong reaction to new smells and tastes

See Videos of 7-9 Month Milestones

10-12 Month Milestones

Motor Milestones
  • Pulls to stand and cruises along furniture
  • Stands alone and takes several independent steps
  • Moves in and out of various positions to explore environment and get desired toys
  • Maintains balance in sitting when throwing objects
  • Claps hands
  • Releases objects into a container with a large opening
  • Uses thumb and pointer finger to pick up tiny objects
Sensory Milestones
  • Enjoys listening to songs
  • Explores toys with fingers and mouth
  • Crawls to or away from objects baby sees in the distance
Communication Milestones
  • Meaningfully uses “mama” or “dada”
  • Responds to simple directions, e. g. “Come here”
  • Produces long strings of gibberish (jargoning) in social communication
  • Says one or two words
  • Imitates speech sounds
  • Babbling has sounds and rhythms of speech
  • Pays attention to where you are looking and pointing
  • Responds to “no”
  • Begins using hand movements to communicate wants and needs, e.g. reaches to be picked up
Feeding Milestones
  • Finger feeds self
  • Eating an increasing variety of food
  • Begins to use an open cup
  • Ready to try soft-cooked vegetables, soft fruits, and finger foods (banana slices, cooked pasta)
  • Might be ready to start self feeding with utensils
  • Enjoys a greater variety of smells and tastes

See Videos of 10-12 Month Milestones

13-18 Month Milestones

Motor Milestones
  • Walks independently
  • Squats to pick up a toy
  • Stacks two objects
Sensory Milestones
  • Helps with getting dressed/undressed
  • Has a regular sleep schedule
  • Eats an increasing variety of foods
Communication Milestones

By 15 months:

  • May use 5-10 words
  • Combines sounds and gestures
  • Imitates simple words and actions
  • Consistently follows simple directions
  • Shows interest in pictures
  • Can identify 1-2 body parts when named
  • Understands 50 words

By 18 months:

  • Responds to questions
  • Repeats words overheard in conversation
  • Continues to produce speech-like babbling
  • Points at familiar objects and people in pictures
  • Understands “in” and “on”
  • Responds to yes/no questions with head shake/nod
Feeding Milestones
  • Increases variety of coarsely chopped table foods
  • Holds and drinks from a cup

See Videos of 13-18 Month Milestones

19-24 Month Milestones

Communication Milestones

By 21 Months:

  • Uses at least 50 words
  • Consistently imitates new words
  • Names objects and pictures
  • Understands simple pronouns (me, you, my)
  • Identifies 3-5 body parts when named
  • Understands new words quickly

By 24 months:

  • Begins to use 2 word phrases
  • Uses simple pronouns (me, you, my)
  • Understands action words
  • Uses gestures and words during pretend play
  • Follows 2-step related directions e. g. “Pick up your coat and bring it to me”
  • Enjoys listening to stories

See Videos of 19-24 Month Milestones

2-3 Year Milestones

Communication Milestones

By 30 months:

  • Consistently uses 2-3 word phrases
  • Uses “in” and “on”
  • At least 50% of speech is understood by caregiver
  • Follows 2-step unrelated directions, e.g. “give me the ball and go get your coat”
  • Understands basic nouns and pronouns
  • Understands “mine” and “yours”

By 36 months:

  • Asks “what” and “where” questions
  • Uses plurals, e.g. “dogs”
  • Most speech is understood by caregiver
  • Simple understanding of concepts including color, space, time
  • Understands “why” questions
  • Understands most simple sentences

Missing Milestones

What to do if your child is not reaching their key developmental milestones

If your child is missing a developmental milestone, request an appointment with a healthcare provider to ask them about how you can get your baby on track!

Remember every baby is different, and milestones typically occur within a general age range.

Baby’s early years are some of the most important years for their development, which is why early detection and early intervention are so critical.

As a general pediatrician I often refer parents to the Pathways.org website for free videos and brochures on tummy time and the stages of infant development.

These resources empower parents to track their babies’ developmental progress and bring their concerns to me quickly so that we can provide resources in a timely and efficient manner.

-Karen R. Judy, M.D. FAAP

Browse our website for additional resources to maximize your child’s motor, sensory, feeding, and communication development!

  • Topics pages: Covering a wide variety of health topics for your baby’s developmental milestones.
  • Videos: Including milestone videos and Parents’ Guide videos, which shows baby’s development in action!
  • Blog posts: In-depth and healthcare provider-approved articles providing important health info to help learn the signs of a delay and when to request an appointment with a healthcare provider.
  • Baby’s First Year Milestone Guide: This helpful guide is a milestone checklist for infants. Keep track of your baby’s developmental milestones through this organized, color-coded, and compact guide. The ultimate resource center for baby’s development!
  • The Baby Games Calendar: If baby enjoys playing, then check out these fun games for infants and toddlers! Baby Games make caring for your baby engaging and interactive, helping with everything from language development to hand eye coordination.

Gross motor skills: birth to 5 years


What are gross motor skills?


Gross motor skill development involves the large muscles in the arms, legs and torso. Gross motor activities are important to everyday physical activities like walking, running, throwing, lifting, kicking, etc. Gross motor abilities also form the basis for fine motor skills and relate to body awareness, reaction speed, balance and strength. Learn more about all developmental milestones by age.


Gross motor development milestones: General physical activity guidelines for children ages 0 to 5 years


Newborn to 2 months


  • Turns head to both sides while on back
  • Lifts head and able to turn to both sides while on belly
  • Head lag with pull to sit
  • Kicking both legs and moving both arms equally while on back
  • Performs tummy time on floor regularly

3-4 months 


  • Raises head in line with trunk when pulled to sit  
  • Pushes up on forearms and turn head side to side while on belly  
  • Tolerates tummy time well   
  • Rolls from belly to back  

5 months 


  • Rolls from back to belly  
  • Brings feet to mouth laying on back  
  • Pushes up on hands with arms extended while on belly  
  • Pivots in a circle while on belly to each side  

6-8 months 


  • Sits alone   
  • Reaches for toys to play in sitting   
  • Catches self with loss of balance in sitting   
  • Crawls on belly  

9-11 months 


  • Moves between laying down and sitting upright without help  
  • Crawls on hands and knees  
  • Pulls to a standing position with one foot leading  
  • Cruises around furniture  
  • Walks with two hands held

11-12 months 


  • Walks with one hand held
  • Stands alone for a few seconds

13-14 months 


  • Crawls up stairs  
  • Stands up from the floor without support   
  • Walks alone well  
  • Squats and stands back up without holding onto support  

15-18 months  


  • Walks up stairs with hands or rails to help  
  • Crawls down the stairs (on belly, feet first)  
  • Can run, though falls easily  
  • Kicks a ball forward

2 years 


  • Walks and runs fairly well   
  • Jumps in place with both feet off the ground  
  • Walks up and down stairs alone  
  • Kicks a ball with either foot

3 years 


  • Balance on one foot for a few seconds   
  • Jump forward 10-24 inches   
  • Catches a large ball   
  • Rides a tricycle

By 4 years 


  • Can run, jump and climb well, is beginning to skip  
  • Hops proficiently on one foot  
  • Can do hopscotch  
  • Catches a ball reliably  
  • Begins somersaults

By 5 years 


  • Skips on alternate feet and jump rope  
  • Begins to skate and swim  
  • Rides bicycle with/without training wheels    
  • Climbs well

This information is a general guide to help you determine if your child is progressing at the rate expected for his or her age. Please keep in mind that each child is unique and develops skills at their own rate.


Physical activity recommendations


By exploring many different types of movement, your child can build the confidence, motivation and physical competence to engage in an active lifestyle.


According to the American Heart Association, a daily dose of at least 60 minutes of moderate-to-vigorous physical activity is recommended for children ages six to seventeen years old. Infants and toddlers are recommended to get 180 minutes of activity spread throughout the day based on the American Academy of Pediatrics. It is suggested that both structured play as well as unstructured play should be incorporated throughout the day.


Ideally, children should participate in 60 minutes of continuous activity. However, for both older children and toddlers the daily amount of activity can be split up throughout the day. For example, two 30-minute segments or four 15-minute segments for children is still beneficial. Whether you’re at home or on the playground, here are some activities, that with proper guidance, may encourage your child to get moving: •


Indoor:


  • Infants/toddlers: crawling and walking over various surfaces such as creating obstacles with pillows and blankets; sitting with support at torso on an exercise ball, mommy/daddy and me classes (yoga, tumbling, swimming)
  • Children: bounce house play, jump rope activities, yoga, dance, gymnastics, cheerleading

Outdoor:


  • Infants/toddlers: mommy/daddy and me swim classes; water play in buckets or playing at water tables; infant/toddler swings or slides at the playground; obstacles over various surfaces such as gravel, grass
  • Children: swimming, sprinkler water play, water parks, marco polo, ice skating, snow tubing, sledding, roller skating, skateboarding, playgrounds, riding scooters, tricycle and bicycle riding, hiking, jumping and hop scotch activities, soccer, baseball, swinging

Our therapy programs can also help bring out the best in your child. From aquatic therapy, to sports therapy and more, our team takes an integrated approach, using the right therapy or therapies your child needs at the right stage in their development. We can help your child learn or regain the skills they need to be successful during everyday activities and participate with peers.


Problems with reaching developmental milestones? How to improve your child’s gross motor skills


If you have concerns regarding your child’s development or your child is regularly missing development milestones, physical therapy can assess development and address concerns. If you are concerned about your child’s development of gross motor skills, a physician or therapist may be able to assist with an evaluation.


Physical therapists can provide a comprehensive examination of your child’s strength, balance, coordination and gross motor skills in order to determine barriers to safe body movement. We provide therapeutic activities that are engaging and specific to a child’s age, cognitive status, ability level and interests.


To make an appointment with a pediatric physical therapist, call one of these locations: 


Information provided by Kristen McBee PT, DPT; Anisha Craft PT, DPT, PCS; Renee Leiby PT, DPT and Jan Steinberger PT, DPT.

Fine motor skills: birth to 2 years


What are fine motor skills?


Generally thought of as the movement and use of hands and upper extremities, fine motor skills include reaching, grasping and manipulating objects with your hands. Fine motor skills also involve vision, specifically visual motor skills, often referred to hand-eye coordination. Visual-motor skills are needed to coordinate hands, legs, and the rest of the body.


The difference between gross and fine motor skills pertains to the muscles being used. Gross motor skills refer to the large muscles and fine motor skills refer to the smaller muscles. Babies and toddlers need a lot of playtime and practice to develop those small muscles needed for fine motor control. Learn more about all developmental milestones by age.


Developmental milestones: Activities for infants and toddlers to build fine motor skills


This is a list of fine motor skills children should demonstrate between the ages of 0-2 years.  


0-3 months  


  • Brings hands to mouth
  • Moves arms
  • May swing arms at toys
  • Hands start to open more

3-6 months


  • Holds small object in hand (without thumb tucked in hand)
  • Holds hands together
  • Reaches for toys with both arms
  • Pushes up on arms when on tummy
  • Briefly holds a toy like a rattle
  • Follows objects with eyes in all directions 

6-9 months


  • Shakes and bangs rattles
  • Brings toys to mouth
  • Uses a raking grasp
  • Transfers objects from one hand to the other
  • Keeps hands open and relaxed most of the time
  • Starting to have the ability to pick up small foods like Cheerios

9-12 months


  • Able to release an object voluntarily 
  • Gives toy to a caregiver when asked 
  • Bangs two toys together
  • Turns pages of a book a few pages at a time
  • Begins to put objects into a container
  • Points to objects
  • Stacks 2 blocks

12-18 months


  • Claps hands together
  • Puts objects and toys into containers
  • Waves goodbye
  • Uses both hands to play 
  • Can isolate index finger with other fingers closed 
  • Scribbles with a crayon
  • Beginning to use a spoon and cup

18-24 months  


  • Can build a block tower using 3-4 blocks 
  • Puts rings on a ring stacker
  • Turns pages of a book one at a time
  • Begins holding crayons with finger tips and thumb

2 to 5 years


Additional ways to help infants develop fine motor skills


You can help your infant develop MOTOR SKILLS by: 


  • “Tummy Time”… An important concept in motor skills development for children ages 0-2 years is what is known as “prone skills. ” Prone refers to lying on your stomach; many therapists call this “tummy time.” A young baby needs to spend playtime in “prone.” Tummy time helps develop postural control and strength to provide stability for hands and fingers. This core stability helps support the development of fine motor skills. Foundational fine motor skills are developed through gross motor skills such as playing in prone, rolling over, sitting up, and crawling.

A 3-6-month-old learns to push up on their elbows in prone and eventually is able to push up onto their hands. These activities are the beginnings of shoulder stability and arch development in the hands, which are used later on for strength and coordination activities, such as pitching a ball, or precise activities, such as writing with a pencil.  


Tummy time also allows for floor time and limits time spent in equipment such as bouncers, infant seats, or swings.


As the development of vision and the sense of touch is important to the development of motor skills, children need to be able to see and feel what is in their hands in order to interact with or manipulate objects.   


Learn more about how tummy time can help your baby


Help your infant develop VISUAL SKILLS by: 


  • Getting close… Young babies like to look at faces. A parent’s face is very expressive and possesses contrast which encourages babies to focus and use their visual skills. Position your face about 12″ from your baby’s face. Sing, talk and make silly faces!  
  • Choosing color… As babies get to be 3-6 months old they begin to enjoy objects with increasing color. Three-month-olds often like “cool colors”- lemon yellow, sky blue and lime green. Six-month-olds are getting ready for brighter colors – hot pink, red and orange.  
  • Exposing your baby to different and enriching visual environments… If you usually have an infant seat in the den, try other rooms so your baby can have different views. If you often carry your baby in a cradle hold through the house, alternate and carry your baby at your shoulder level so he/she can view the world with an upright head posture.  

Help your infant develop SENSORY SKILLS by: 


  • Incorporate multiple senses…When interacting with your baby remember all the senses: touch (tactile), movement (vestibular), body awareness (proprioceptive), sight, smell, hearing, and taste. Play mats with different textures and touch and feel books offer different tactile experiences. Rocking, swaying, and gentle bouncing provide varied movement experiences. As mentioned earlier using toys with different colors and playing in different environments offers different visual experiences. Using lightly scented lotions or letting you baby smell garden herbs can stimulate sense of smell. Listening to music and playing with instruments are good ways to provide auditory input. Once your baby is eating a variety of solid foods, at around five to six months of age, experimenting with a variety of tastes, textures, and colors is a great way to broaden her culinary (and sensory) horizons.  
  • Positioning… Our senses of vision, hearing, touch, taste and smell are all developing in a young infant. We also have a “positional sense”; this helps us to define if our body is moving, and where we are in space (sitting up or lying on our stomach). This positional sense is why babies like to be rocked. To help them have an enriched environment, alternate rocking with swaying, try different rocking chairs, and change the baby’s position – swaddled in a blanket, upright on your shoulder, or lying on their stomach across your lap. Go for walks with your baby in a baby-wearing carrier or backpack for stimulation.  
  • Massaging… For development of touch sense or tactile awareness, provide your infant with massage to arms, legs and trunk. You can use baby lotion or oils if you like. Many YMCAs and other organizations offer classes for infant massage. This activity is great for bonding time with your child. 

How to improve your child’s fine motor skills


If your child is regularly missing development milestones, occupational therapy addresses challenges related to cognitive, daily living, motor, sensory processing, social and visual/perceptual skill development.   


Occupational therapists at CHoR can provide a comprehensive examination of your child’s strength, balance, coordination and fine motor skills in order to determine barriers to safe body movement. We provide therapeutic activities that are engaging and specific to a child’s age, cognitive status, ability level and interests. We strive to help a child and his or her family succeed through developing strategies unique to a child’s specific needs and abilities.


To make an appointment with a pediatric therapist, call one of these locations: 


Information provided by Sallie Tidman, OT/L, Director of Therapy Services, and occupational therapist’s Katie Bobbit, Megan Stratton, and Melanie Koch

Gross Motor Milestones – Therapies For Kids

What are Gross Motor Milestones?

Your child’s ability to control movements and respond to his/her environment begins to develop even before birth. Each baby is unique and grows at his/her own rate. That is why there is a wide variety of “normal” in development. Although this is a gradual, individualised
process, most babies do go through a series of developmental milestones around certain ages.

The purpose of this checklist is to provide a reference to help guide you through your child’s development and what to expect at certain stages.

Birth-2 months

  • Raises head slightly off floor or bed when on stomach

  • Holds head up momentarily when supported
  • Alternates kicking legs when on back
  • Arm thrusts in play

3-5 months

  • Lifts head and chest when on stomach (props on forearm)
  • Head control improving
  • Some head-bobbing in supported sitting
  • Rolls from side to side
  • Rolls from stomach to back
  • Sits briefly with arm support
  • Random batting at objects
  • Hands to midline
  • Makes crawling movements

6-8 months

  • Reaches to objects on stomach
  • Pivots around when on stomach
  • Pulls self forward on stomach
  • Rolls from back to stomach
  • Sits alone briefly
  • Moves from sitting to lying on stomach
  • Stands with support
  • Assumes quadruped and rocks

9-11 months

  •  Sits alone with trunk rotation
  • Pivots and scoots in sitting
  • Creeps or crawls
  • Pulls to stand
  • Cruises
  • Stands alone momentarily

12-15 months

  • Assumes tall kneeling
  • Walks on knees
  • Walks independently without support
  • Able to stand without support
  • Creeps up stairs
  • Able to start, stop and turn without falling while walking
  • Crawls up on chairs or other furniture
  • Runs

16-18 months

  • Walks up one step at a time with hand held or railing
  • Creeps down stairs
  • Walks with a heel-toe pattern seldom falls
  • Walks sideways and backward
  • Run stiffly
  • Stands on one foot with help
  • Kicks large ball forward after a demonstration
  • Manages riding toys
  • Good balance and coordination

19-24 months

  • Walks down one step at a time with rail or hand-holding
  • Squats in play and stands back up
  • Jumps in place
  • Kicks a stationary ball
  • Jumps off 12-inch box with 1 foot leading
  • Walks on balance beam with 1 foot on/ 1 foot off
  • Walks up and down stairs alone

24-29 months

  • Walks on balance beam with one hand held
  • Stands on balance beam alone
  • Walks up stairs one step at a time with no railing
  • Runs well
  • Briefly stands on one foot
  • Jumps from one step with feet together
  • Throws ball overhead
  • Climbs on play equipment-ladders, slides, etc.

2-3 years

  • Walks down stairs step by step without a railing
  • Balances on one foot 2-3 seconds
  • Jumps forward at least one foot
  • Walks on balance beam alone
  • Walks on tiptoe when asked

3-4 years

  • Walks on balance beam sideways
  • Catches a bounced ball
  • Rides a tricycle
  • Hops on one foot 2-5 times
  • Balances on one foot 2-5 seconds
  • Consecutive jumping
  • Walks up stairs step over step alone

4-5 years

  • Balances on one foot 4-8 seconds
  • Walks on balance beam in all directions
  • Walks down stairs step over step alone
  • Kicks a rolling ball
  • Catches large and small ball with an outstretched arm
  • Throw a small ball overhand

5-6 years

  • Balances on one foot 10 seconds
  • Skips
  • Rides a bike with or without training wheels
  • Begins to jump rope
  • Hops on one foot ten times
  • Catches bounced or thrown ball with hands
  • Walks on heals when asked
  • Swings on a swing, pumping by self

What Therapies for Kids can do

If you have any concerns regarding your child’s Gross Motor development we can provide:

  • Assessment of your child’s motor skills
  • Reassurance and  further information on gross motor skills
  • Advice on promoting motor development
  • Referral to an appropriate medical practitioner if necessary

What you can do

You as parents and caregivers are the best at determining whether your child is having difficulties in their development. Trust your judgment! If you have concerns, don’t hesitate to bring them to the attention of your doctor, community nurse, or paediatric physiotherapist. Give your child multiple opportunities to practice motor skills.

newborn development: MedlinePlus Medical Encyclopedia

Infant development is most often divided into the following areas:

  • Cognitive
  • Language
  • Physical, such as fine motor skills (holding a spoon, pincer grasp) and gross motor skills (head control, sitting, and walking)
  • Social


PHYSICAL DEVELOPMENT

An infant’s physical development begins at the head, then moves to other parts of the body. For example, sucking comes before sitting, which comes before walking.

Newborn to 2 months:

  • Can lift and turn their head when lying on their back
  • Hands are fisted, the arms are flexed
  • Neck is unable to support the head when the infant is pulled to a sitting position

Primitive reflexes include:

  • Babinski reflex, toes fan outward when sole of foot is stroked
  • Moro reflex (startle reflex), extends arms then bends and pulls them in toward body with a brief cry; often triggered by loud sounds or sudden movements
  • Palmar hand grasp, infant closes hand and “grips” your finger
  • Placing, leg extends when sole of foot is touched
  • Plantar grasp, infant flexes the toes and forefoot
  • Rooting and sucking, turns head in search of nipple when cheek is touched and begins to suck when nipple touches lips
  • Stepping and walking, takes brisk steps when both feet are placed on a surface, with body supported
  • Tonic neck response, left arm extends when infant gazes to the left, while right arm and leg flex inward, and vice versa

3 to 4 months:

  • Better eye-muscle control allows the infant to track objects.
  • Begins to control hand and feet actions, but these movements are not fine-tuned. The infant may begin to use both hands, working together, to accomplish tasks. The infant is still unable to coordinate the grasp, but swipes at objects to bring them closer.
  • Increased vision allows the infant to tell objects apart from backgrounds with very little contrast (such as a button on a blouse of the same color).
  • Infant raises up (upper torso, shoulders, and head) with arms when lying face down (on tummy).
  • Neck muscles are developed enough to allow the infant to sit with support, and keep head up.
  • Primitive reflexes have either already disappeared, or are starting to disappear.

5 to 6 months:

  • Able to sit alone, without support, for only moments at first, and then for up to 30 seconds or more.
  • Infant begins to grasp blocks or cubes using the ulnar-palmar grasp technique (pressing the block into palm of hand while flexing or bending wrist in) but does not yet use thumb.
  • Infant rolls from back to stomach. When on tummy, the infant can push up with arms to raise the shoulders and head and look around or reach for objects.

6 to 9 months:

  • Crawling may begin
  • Infant can walk while holding an adult’s hand
  • Infant is able to sit steadily, without support, for long periods of time
  • Infant learns to sit down from a standing position
  • Infant may pull into and keep a standing position while holding onto furniture

9 to 12 months:

  • Infant begins to balance while standing alone
  • Infant takes steps holding a hand; may take few steps alone


SENSORY DEVELOPMENT

  • Hearing begins before birth, and is mature at birth. The infant prefers the human voice.
  • Touch, taste, and smell, mature at birth; prefers sweet taste.
  • Vision, the newborn infant can see within a range of 8 to 12 inches (20 to 30 centimeters). Color vision develops between 4 to 6 months. By 2 months, can track moving objects up to 180 degrees, and prefers faces.
  • Inner ear (vestibular) senses, the infant responds to rocking and changes of position.


LANGUAGE DEVELOPMENT

Crying is a very important way to communicate. By the baby’s third day of life, mothers can tell their own baby’s cry from that of other babies. By the first month of life, most parents can tell if their baby’s cry means hunger, pain, or anger. Crying also causes a nursing mother’s milk to letdown (fill the breast).

The amount of crying in the first 3 months varies in a healthy infant, from 1 to 3 hours a day. Infants who cry more than 3 hours a day are often described as having colic. Colic in infants is rarely due to a problem with the body. In most cases, it stops by 4 months of age.

Regardless of the cause, excessive crying needs a medical evaluation. It can cause family stress that can lead to child abuse.

0 to 2 months:

  • Alert to voices
  • Uses range of noises to signal needs, such as hunger or pain

2 to 4 months:

4 to 6 months:

  • Makes vowel sounds (“oo,” “ah”)

6 to 9 months:

  • Babbles
  • Blows bubbles (“raspberries”)
  • Laughs

9 to 12 months:

  • Imitates some sounds
  • Says “Mama” and “Dada,”, but not specifically for those parents
  • Responds to simple verbal commands, such as “no”


BEHAVIOR

Newborn behavior is based on six states of consciousness:

  • Active crying
  • Active sleep
  • Drowsy waking
  • Fussing
  • Quiet alert
  • Quiet sleep

Healthy babies with a normal nervous system can move smoothly from one state to another. Heart rate, breathing, muscle tone, and body movements are different in each state.

Many bodily functions are not stable in the first months after birth. This is normal and differs from infant to infant. Stress and stimulation can affect:

  • Bowel movements
  • Gagging
  • Hiccupping
  • Skin color
  • Temperature control
  • Vomiting
  • Yawning

Periodic breathing, in which breathing starts and stops again, is normal. It is not a sign of sudden infant death syndrome (SIDS). Some infants will vomit or spit up after each feeding, but have nothing physically wrong with them. They continue to gain weight and develop normally.

Other infants grunt and groan while making a bowel movement, but produce soft, blood-free stools, and their growth and feeding are good. This is due to immature abdominal muscles used for pushing and does not need to be treated.

Sleep/wake cycles vary, and do not stabilize until a baby is 3 months old. These cycles occur in random intervals of 30 to 50 minutes at birth. Intervals gradually increase as the infant matures. By age 4 months, most infants will have one 5-hour period of uninterrupted sleep per day.

Breast-fed infants will feed about every 2 hours. Formula-fed infants should be able to go 3 hours between feedings. During periods of rapid growth, they may feed more often.

You do not need to give water to a baby. In fact, it could be dangerous. An infant who is drinking enough will produce 6 to 8 wet diapers in a 24-hour period. Teaching the infant to suck a pacifier or their own thumb provides comfort between feedings.


SAFETY

Safety is very important for infants. Base safety measures on the child’s developmental stage. For example, around age 4 to 6 months, the infant may begin to roll over. Therefore, be very careful while the baby is on the changing table.

Consider the following important safety tips:

  • Be aware of poisons (household cleaners, cosmetics, medicines, and even some plants) in your home and keep them out of your infant’s reach. Use drawer and cupboard safety latches. Post the national poison control number — 1-800-222-1222 — near the phone.
  • DO NOT allow older infants to crawl or walk around in the kitchen while adults or older siblings are cooking. Block the kitchen off with a gate or place the infant in a playpen, highchair, or crib while others cook.
  • DO NOT drink or carry anything hot while holding the infant to avoid burns. Infants begin waving their arms and grabbing for objects at 3 to 5 months.
  • DO NOT leave an infant alone with siblings or pets. Even older siblings may not be ready to handle an emergency if it occurs. Pets, even though they may appear to be gentle and loving, may react unexpectedly to an infant’s cries or grabs, or may smother an infant by lying too closely.
  • DO NOT leave an infant alone on a surface from which the child can wiggle or roll over and fall off.
  • For the first 5 months of life, always place your infant on their back to go to sleep. This position has been shown to reduce the risk for sudden infant death syndrome (SIDS). Once a baby can roll over by himself, the maturing nervous system greatly reduces the risk for SIDS.
  • Know how to handle a choking emergency in an infant by taking a certified course through the American Heart Association, the American Red Cross, or a local hospital.
  • Never leave small objects within an infant’s reach, infants explore their environment by putting everything they can get their hands on into their mouth.
  • Place your infant in a proper car seat for every car ride, no matter how short the distance. Use a car seat that faces backward until the infant is at least 1 year old AND weighs 20 pounds (9 kilograms), or longer if possible. Then you can safely switch to a forward facing car seat. The safest place for the infant’s car seat is in the middle of the back seat. It is very important for the driver to pay attention to driving, not playing with the infant. If you need to tend to the infant, safely pull the car over to the shoulder and park before trying to help the child.
  • Use gates on stairways, and block off rooms that are not “child proof.” Remember, infants may learn to crawl or scoot as early as 6 months.


CONTACTYOUR HEALTH CARE PROVIDER IF:

  • The infant does not look good, looks different from normal, or cannot be consoled by holding, rocking, or cuddling.
  • The infant’s growth or development does not appear normal.
  • Your infant seems to be “losing” developmental milestones. For example, if your 9-month-old was able to pull to standing, but at 12 months is no longer able to sit unsupported.
  • You are concerned at any time.

Fine Motor Skills – Infant Developmental Milestones

Fine Motor Skills

“Fine motor” refers to the movements we make with the small muscles of the hands. Children start to use their hands right at birth to explore their own bodies and the world around them. Their fine motor skills develop as their whole body starts to move and become more stable.  They also learn to do more things with their hands as their cognitive and social/emotional skills improve.  

Below are some of the typical developmental milestones for fine motor skills.  After each age group, you can find some “red flags” that might indicate a problem.

Between the ages of 0-4 months, your baby will:

  • Turn her head toward sounds and voices
  • Stare at bright objects and follow them with his eyes
  • Move her arms together and apart
  • Bring his hands to his mouth, and possibly suck on his own hands or fingers
  • By 4 months, lift his head and shoulders off the floor when laying on his tummy

Between the ages of 4-8 months, your baby will:

  • Grab onto objects within her reach
  • Roll over to explore and get to objects
  • Prop himself up on his arms when laying on his tummy
  • Sit independently for brief periods
  • Pass objects from one hand to the other hand

Red Flags for Fine Motor Development (0-8 months)

If you notice some of the following things about your baby by the time she is 6-8 months old, you may want to talk to your doctor, or to another health professional such as an occupational therapist or a physiotherapist.

  • She still keeps one or both hands clenched in a fist
  • His arms seem very stiff
  • She is not able to prop herself up when laying on his tummy
  • She is not able to pick up objects within her reach
  • He is not able to sit by himself for short periods
  • He is not able to roll over to get objects

Between the ages of 8-12 months, your baby will:

  • Reach, grab, and put objects in her mouth
  • Pinch small objects (e.g. cheerios) with thumb and pointer finger
  • Move objects from one hand to the other
  • Drop and pick up toys
  • Bang two objects together
  • Let go of objects on purpose
  • Put things into containers (with large openings) and take them out again
  • Bite and chew toys
  • Hold a spoon (but not yet feed herself)
  • Hold his own bottle
  • Hold out an arm or leg to help with dressing
  • Wave hello or goodbye

Red Flags for Fine Motor Development (12 months)

If you notice some of the following things about your child by the time he is 12 months old, you may want to talk to your doctor, or to another health professional such as an occupational therapist or a physiotherapist.

  • He is not able to grasp toys and let them go again
  • She does not bring toys to her mouth or bang them together
  • He is not able to bring his hands together at the middle of his body (e.g. clapping)
  • She is not able to feed herself finger foods, using her thumb and pointer finger to pick up food
  • His movements seem shaky or stiff
  • He is not able to move around on the floor to get the toys he wants
  • She is not able to put objects into a large container
  • His hands are kept in a fisted position
  • She is not able to hold her bottle by herself

If you have concerns about your child at any age, please feel free to contact us to speak to a professional. You can also make a referral to our centre at anytime.

Is Your Baby’s Physical Development on Track?


You know your child best. So, it’s important you share your concerns with your pediatrician if you think your little one’s development isn’t exactly on track.

Typically, children develop motor skills from the head down. First comes head control and then control over the upper body. The typical pattern for motor milestones is rolling over, then sitting, pulling up, standing, walking, and climbing. Small, fine motor skills, such as grasping objects, putting blocks in a cup, and scribbling are important milestones, too.


Physical developmental delays or
early motor delays are terms used to describe when children are not meeting critical physical milestones in the first months and years of life – how well and soon they move and interact with their environment. These delays can be a sign of something more serious, so it is important to talk with your child’s pediatrician about them.

Signs of a Physical Developmental or Early Motor Delay

  • Delayed rolling over, sitting, or walking

  • Poor head and neck control

  • Muscle stiffness or floppiness

  • Speech delay

  • Swallowing difficulty

  • Body posture that is limp or awkward

  • Clumsiness

  • Muscle spasms

Common Concerns from Parents about Delayed Physical Development

  • ​My child doesn’t seem to be growing the way he should.

  • My child seems very stiff and tight in the way she moves.

  • My child is weak and limp like a rag doll.

  • My child isn’t keeping up with children of the same age when they play together.

  • My child seems to get tired very quickly.


If either of the above lists of signs and concerns sound familiar or if you have other any other worries, speak up! Usually a child who is late doing certain activities catches up to other children. But sometimes, developing late is the sign of a health condition. An estimated 400,000 babies born each year in the United States are at risk for some form of neuromuscular condition, and one in 40 are actually born with an early motor delay. Spotting these signs and finding the health condition as early as possible will help your child get the care he or she needs.

Physical Developmental Delays: What to Look For


When trying to spot an early motor delay, it is helpful to know the signs of typical and atypical physical development. The American Academy of Pediatrics (AAP), created an online tool for parents called
Physical Developmental Delays: What to Look For.
This tool features an interactive experience to learn more about physical developmental delays in children 5 and under and can serve as a guide if you have a feeling that something is wrong. You are also able to create a checklist of items to help start a conversation with your child’s pediatrician.


Note: This tool only focuses on a child’s physical development. If you’re worried about other developmental issues, like social, emotional, communication, or learning, visit the
Learn the Signs. Act Early. Also, keep in mind that if your child was born prematurely (before 37 weeks of pregnancy) he or she may develop later than other children the same age. See
Preemie Milestones.

Next Step: Talk with Your Pediatrician

When you express concerns your child is development to the pediatrician, he or she will listen carefully and may ask you some additional questions. You may also be asked to complete screening questionnaire online or on paper; this is an
assessment for developmental delays. Parent observations are an important part of a pediatrician’s evaluation. Pediatricians use parental input on these questionnaires as a basis for further examination and referral. See these
tips from the CDC for talking with your child’s pediatrician about development.

Finding Support if a Health Condition is Identified

If a specific diagnosis is found in your child, your pediatrician can help you connect with special support groups and other resources for parents in your community. Parent support organizations such as
Parent Project Muscular Dystrophy help you figure out what to do, especially in the first few weeks following a diagnosis, and offer you support in parenting a child with a special need. Some other conditions have well organized societies, such as the
National Down Syndrome Society,
United Cerebral Palsy, and the
Muscular Dystrophy Association.

More Information

Movement Milestones: Birth to 3 Months

AAP Motor Delay Tool​

Simple Ways to Entertain & Boost Your Baby’s Development at Home​


The
Physical Developmental Delay: What to Look For
tool was developed by the cooperative agreement number 5 U38 OT000183, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the American Academy of Pediatrics and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services.


The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

90,000 exercise therapy for children – in St. Petersburg next to the metro!

Exercise therapy for kids – we develop by playing!

If a child needs physical therapy, he will work with an instructor in exercise therapy. Such specialists provide assistance in the physical development and restoration of functions in children under 18 years old, from newborns to adolescents. Children come to physical therapy for various reasons, including problems with the musculoskeletal system, sports and rubble injuries, genetic diseases, diseases of the brain, spine or nervous system.Physiotherapy specialists work with children after surgery or injury to improve their mobility during rehabilitation. Exercise therapy can address many mobility problems, including muscle weakness, decreased flexibility, poor posture, difficulty walking, imbalance, and pain on movement.


Exercise therapy helps children improve range of motion, strength, flexibility, coordination and balance. Children learn to control their bodies, increase the range of motor abilities and the quality of daily activities and self-care.

Regardless of the age of the patient, the exercise therapy specialist works with the same basic deficiencies or problems, but in the context of age milestones and norms for the development of mobility and movement in infants, toddlers and children. With infants, instructors work primarily on the development of general motor skills to help them learn to move in the world around them. This includes learning how to roll over, sit, crawl, stand, and walk.

How do I know if my child needs physiotherapy exercises?

Perhaps exercise therapy will be beneficial to health and physical fitness in the following cases:

  • After injury (in a fall, during a sporting event)
  • Post-operation
  • If the child frequently falls, stumbles or loses balance
  • If it is difficult for a child to keep up with peers on the playground or at school
  • When it is difficult for a child to coordinate their movements, including when performing tasks such as jumping
  • If your child chronically complains of pain in the same part of the body
  • If your child has a delay in motor development

What is developmental delay?

Developmental delay is diagnosed when a child is found to be more than “slightly behind” in the acquisition of daily motor skills that correspond to developmental control milestones.This term identifies significant lag, and can be used to describe any type of lag in one or more of the following 5 skill areas:

  1. Fine and gross motor skills
  2. Cognitive skills (thinking)
  3. Social and Emotional Skills
  4. Speech and Language
  5. Self Service

These delays may or may not be the result of a specific medical condition. For example, a child with Down syndrome is diagnosed at birth or before birth, but may also have developmental delays.This is true for any child with a disability such as autism spectrum disorder or cerebral palsy. However, children without a specific medical condition may also have developmental delays. Early assessment is key. Parents should express any concerns, even the smallest, to their pediatrician in order to confirm or rule out developmental delay.

Preventing developmental delay can be challenging if unrelated to a specific medical condition – its causes may remain unclear.However, once developmental delay is diagnosed, steps need to be taken to prevent further delay or to help the child “catch up”. Since this diagnosis is very diverse, the results of the intervention also vary. It is important to remember that the sooner assistance is provided, the more likely the child will be able to recover and will not continue to lag behind.


Major milestones in child motor development

Delayed motor development occurs when a child does not reach certain “motor milestones” at the expected age.Children usually develop their general motor skills, such as rolling, crawling, and walking, in a predictable sequence and within a predictable amount of time. The milestones in gross motor development are shown in the table below, with expected ages. If the development of motor skills does not meet these milestones, then the exercise therapy specialist can help the child develop the appropriate functions and improve motor skills.

Age

Milestones in motor development

3-4 months

Keeps the head in different positions

5-6 months

Rolls over over the tummy onto the back and back onto the belly

6-7 months

Sits well on its own

8-10 months

Creeps

9-11 months

Reaches to get up

11-14 months

Starts a walk with a support and then walks on its own.

~ 2 Years

Starts running, jumping and jumping

~ 3 Years

Learns to stand on one leg

~ 4-5 years

Learns to jump and jump


Signs and symptoms of delayed motor development

Parents are often the first to notice that a child is not reaching the above developmental milestones.However, a delay in reaching a milestone does not necessarily mean that a child has a developmental delay. Children need to demonstrate significant developmental delays in one or more areas of development to be diagnosed.

For example, in infancy, a child is initially suspected of developmental delay if general motor milestones are not followed, such as:

  • Ability to hold head up at 4 months
  • Ability to sit at about 6 months of age
  • Ability to walk at the age of about a year.

May be suspected of delayed motor development if children try to master movement skills in various ways. Occasionally, children with motor retardation may have an additional diagnosis, such as hypotension (low muscle tone), which aggravates their movement difficulties.

Motor development in children may often be the first area of ​​delay that parents notice. However, in infants and young children, all areas of development are closely related: a delay in one area can affect progress in another.For example, failing to learn to sit or change position can affect learning or babbling and language development. Sensory problems such as hypersensitivity to touch or an inability to plan and solve problems of how to move can also exacerbate movement difficulties.

Children who have some or all of these problems that interfere with their motor development may also develop a fear of trying new motor skills, which can then lead to social or emotional problems.


How is developmental delay diagnosed?

Parents should talk to their pediatrician about any problems they see in relation to their child’s development. A doctor can identify medical problems that may affect overall development, such as chronic ear infections that impair hearing and affect a child’s speech or balance.

Developmental delay is diagnosed using tests designed to evaluate a child’s movement, communication, play and other behavior compared to other children of the same age.These tests are standardized to determine the normal range of scores for each age. If children are gaining much less than the average for their age, they are at risk of being diagnosed with developmental delays.

Pediatricians routinely perform screening tests during infancy to determine if a child is developing at a rate appropriate for age. Often this happens at the request of parents who suspect that the child does not have the same skills as other children of the same age.The screening test helps determine which children would benefit from a deeper examination. A physical therapist with knowledge of movement development, coordination, and health conditions will conduct an in-depth examination to determine if a child’s motor skills are being delayed, and if so, how much they are.

How can a physiotherapist and exercise therapy specialist help?

The specialist will first assess the child with appropriate tests to determine his strengths and weaknesses.The doctor will discuss observations and concerns with the parents. If your child is diagnosed with developmental delay, your physical therapist will talk with you about your family’s daily routine and environment to find ways to improve and develop your child’s developmental skills.

In addition to assessing the child and the environment in which he moves, the exercise therapy specialist can give detailed instructions on the development of motor skills, step by step, to achieve the set goals. The therapist can guide the child’s movements or give hints to help the child learn a new way of moving.For example, if a child has difficulty getting up to a standing position, the instructor can show him how to bend forward and kick off with his feet. If the child is unable to balance while standing, the instructor can experiment with different support aids so that the child can safely learn new ways to stand.

Also, during the exercise therapy course, the family will be taught what can be done to help the child practice skills during daily activities. The family has the most important influence on a child because they can provide the opportunities they need to achieve each new skill.The exercise therapy specialist will explain how much practice is needed to reach a certain milestone. For example, a child who learns to walk makes a long journey during the day. The instructor can give specific advice on the number and type of activities that are appropriate for the child at each stage of development.


How are the exercises of exercise therapy at the DMC “Aqua-Doctor”:

Most often, babies are given gentle massage, stretching exercises, passive movements to develop joints and muscles, develop the ability to control the head, develop flexibility and balance.For each child in our center, the exercise therapy doctor conducts diagnostics, and, based on the diagnosis, develops an individual exercise therapy course, selects a set of exercises, calculates the duration of the course, the frequency of exercises, and the required load. “Aqua-Doctor” is a unique children’s medical center with special pools, therefore, it is possible to add the healing power of exercise in warm water to the usual procedures of exercise therapy. After consulting an exercise therapy doctor, physiotherapy, a course of massage and osteopathy, or infant swimming classes, combining therapeutic exercises and exercises in water, may be included in the complex of therapeutic measures for a baby, after consulting an exercise therapy doctor.

Physical therapy has a positive effect on the musculoskeletal system, respiratory and cardiovascular system, nervous system, has a beneficial effect on the psychoemotional state of the child, promotes optimal early development.

DMC “Aqua-Doctor” – a modern formula for your child’s health!


The information and prices presented on the site are for reference only and are not a public offer. The services specified in the Price List can be provided in other medical centers of VIRILIS Group of Companies.We ask you to specify in advance the address and cost of services in the round-the-clock contact center by phone +7 (812) 331 88 95

90,000 The child does not crawl on all fours.


02/15/2021